Eureka! Institutional Repository

Rheumatic diseases (RDs) are a wide range of connective tissue disorders and dysfunctions. Ceramides are well-known signaling molecules, regulating inflammation through many different pathways, many of which are sometimes intersecting. Studies reveal that there are differences in the concentrations of ceramides in patients with RDs and in healthy populations, even between patients with the same diagnosis but different progression or severity of the disease, while they are also related to comorbidities. In this thesis a literature review was carried out and the existing evidence relating ceramides and sphingolipids to RDs was investigated. The aim of the study was: a) To investigate the correlations between the levels and types of ceramides in patients with RDs, b) to describe in detail the effects of therapeutic approaches against ceramides concerning nutritional patterns, c) the possibility of using medical nutritional therapy as adjunctive anticeramide therapy in RDs, d) the investigation of other possible uses of ceramides in rheumatic diseases. The results showed differences in the levels and types of ceramides between RDs patients and healthy populations, with differences to be occurred even between patients with the same diagnosis but different disease progression or severity. They also appeared to be related to comorbidities that occur in RDs, such as dyslipidemias and an increased risk of cardiovascular disease. Correlations were also found between ceramide levels and: intake of supplements, intake of saturated fatty acids (positive association), intake of mono- and polyunsaturated fatty acids (negative association, atherogenic species of ceramides), but also non-dietary associations (exercise, surgery, etc.). Finally, their possible uses as therapeutic targets, but also as diagnostic biomarkers, were found. Ceramides are potential profitable therapeutic approaches (dietary, as therapeutic targets, as biomarkers), which will contribute to reducing the severity of RDs complications and improving their progression, as well as reducing comorbidities.